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一种用于下颌骨的正畸微螺钉的开发及体外测试。

Development and in vitro testing of an orthodontic miniscrew for use in the mandible.

作者信息

Bauer Carolien A J, Karl Pauline A M, Mielke Juliana M-K, Roser Christoph J, Lux Christopher J, Scheurer Mats, Keilig Ludger, Bourauel Christoph, Hodecker Lutz D

机构信息

Poliklinik für Kieferorthopädie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.

Klinik und Poliklinik für Mund‑, Kiefer‑, Gesichtschirurgie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.

出版信息

J Orofac Orthop. 2025 Aug;86(Suppl 1):100-110. doi: 10.1007/s00056-024-00560-z. Epub 2024 Nov 26.

Abstract

OBJECTIVE

Temporary anchorage devices (TADs) have been successfully used in the maxilla. However, in the mandible, lower success rates present a challenge in everyday clinical practice. A new TAD design will be presented that is intended to demonstrate optimization of the coupling structure as well as in the thread area for use in the mandible.

METHODS

Three TADs were examined: (A) Aarhus® system (68.99.33 A, Medicon, Tuttlingen, Germany), (B) BENEfit® orthodontic screw (ST-33-54209; PSM Medical, Gunningen, Germany) and (C) a new design with a two-part screw thread. The TADs were inserted into artificial bone blocks after predrilling to test primary stability. To test the fracture stability, the TADs were embedded in Technovit® 4004 (Heraeus Kulzer, Wehrheim, Germany) and torsional loaded at an angle of 90° until fracture. The threshold torque values occurring were recorded digitally. The statistical evaluation was carried out using the Kruskal-Wallis test with a post hoc test according to Bonferroni (p < 0.05).

RESULTS

The following values were measured for the insertion torque: A: 33.7 ± 3.3 Ncm; B: 57.1 ± 8.4 Ncm; C: 34.2 ± 1.4 Ncm. There were significant differences between A-B and B-C. The measured values for the fracture strength were as follows: A: 46.7 ± 3.5 Ncm; B: 64.2 ± 5.1 Ncm; C: 55.4 ± 5.1 Ncm. Significant differences were found between all groups.

CONCLUSION

The adapted screw design has no negative influence on primary and fracture stability. Whether the design has a positive effect on the success rates in the mandible must be clarified in further clinical studies.

摘要

目的

临时锚固装置(TADs)已成功应用于上颌骨。然而,在下颌骨中,较低的成功率给日常临床实践带来了挑战。本文将介绍一种新的TAD设计,旨在展示其连接结构以及用于下颌骨的螺纹区域的优化。

方法

对三种TAD进行了检测:(A)奥胡斯®系统(68.99.33 A,Medicon,德国图特林根),(B)BENEfit®正畸螺钉(ST-33-54209;PSM Medical,德国贡宁根)和(C)一种带有两部分螺纹的新设计。在预钻孔后将TAD插入人工骨块中以测试初始稳定性。为了测试断裂稳定性,将TAD嵌入Technovit® 4004(德国韦尔海姆贺利氏古莎)中,并以90°角进行扭转加载直至断裂。记录出现的阈值扭矩值。使用Kruskal-Wallis检验并根据Bonferroni进行事后检验(p < 0.05)进行统计评估。

结果

测量得到的插入扭矩值如下:A:33.7 ± 3.3 Ncm;B:57.1 ± 8.4 Ncm;C:34.2 ± 1.4 Ncm。A与B以及B与C之间存在显著差异。测量得到的断裂强度值如下:A:46.7 ± 3.5 Ncm;B:64.2 ± 5.1 Ncm;C:55.4 ± 5.1 Ncm。所有组之间均发现显著差异。

结论

改进后的螺钉设计对初始稳定性和断裂稳定性没有负面影响。该设计在下颌骨成功率方面是否具有积极作用,必须在进一步的临床研究中加以阐明。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc12/12394319/8a379abb7063/56_2024_560_Fig1_HTML.jpg

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